Colon cancer:a civilization disorder

Watson, Alastair J M and Collins, Paul D (2011) Colon cancer:a civilization disorder. Digestive Diseases, 29 (2). pp. 222-228. ISSN 1421-9875

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    Abstract

    Colorectal cancer arises in individuals with acquired or inherited genetic predisposition who are exposed to a range of risk factors. Many of these risk factors are associated with affluent Western societies. More than 95% of colorectal cancers are sporadic, arising in individuals without a significant hereditary risk. Geographic variation in the incidence of colorectal cancer is considerable with a higher incidence observed in the West. Environmental factors contribute substantially to this variation. A number of these risk factors are associated with a Western lifestyle and could be considered a product of 'civilization'. Recently, smoking has been recognized as a risk factor. Energy consumption also influences colorectal cancer risk, with obesity increasing risk and exercise reducing risk. However, the strongest contribution to environmental risk for colorectal cancer is dietary. Consumption of fat, alcohol and red meat is associated with an increased risk. Fresh fruit and vegetables and dietary fibre may be protective. Much has been learnt recently about the molecular pathogenesis of colorectal cancer. Colorectal cancer always arises in the context of genomic instability. There is inactivation of the tumour suppressor genes adenomatous polyposis coli, p53, transforming growth factor-β, activation of oncogene pathways including K-ras, and activation of the cyclooxygenase-2, epidermal growth factor receptor and vascular endothelial growth factor pathways. The mechanisms by which some environmental factors modify the mutation risk in these pathways have been described.

    Item Type: Article
    Additional Information: Copyright © 2011 S. Karger AG, Basel.
    Uncontrolled Keywords: civilization,colonic neoplasms,humans,incidence,life style,precancerous conditions
    Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
    University of East Anglia > Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology
    Depositing User: Pure Connector
    Date Deposited: 07 Jul 2014 14:42
    Last Modified: 25 Jul 2018 09:45
    URI: https://ueaeprints.uea.ac.uk/id/eprint/48949
    DOI: 10.1159/000323926

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